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Human Needs > GI Assessment, Nutritional Problem, Obesity, Cancers > Flashcards

GI Assessment, Nutritional Problem, Obesity, Cancers Flashcards

1
Q

How do you palpate the liver?

A
  • left hand on back to support right 11th & 12th ribs
  • Right hand lateral to RUQ
  • patient takes deep breath
  • should feel firm, sharp, & smooth
  • withdrawal pain = inflammation
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2
Q

Liver Biopsy Preop

A
  • VS
  • withhold food for 8-12 hrs
  • check coagulation status
  • sedative
  • obtain type & crossmatch
  • patient teaching & consent
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3
Q

Liver Biopsy Post Op

A
  • VS for internal bleeding
  • notify of dyspnea & cyanosis (pneumothorax)
  • keep patient lying on right side for minimum of 2 hrs
  • bed rest 12-14 hrs
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4
Q

Enteral Nutrition Complications

A
  • clogged tube
  • improper positioning
  • aspiration
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5
Q

Parenteral Tube Complications

A
  • refeeding syndrome
  • infection & septicemia
  • changes in pulmonary status
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6
Q

What is refeeding syndrome characterized by?

A
  • fluid retention
  • electrolyte imbalances
  • hyperglycemia
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7
Q

Malnutrition Planning

A
  • achieve appropriate weight
  • consume a certain # of calories per day
  • no adverse consequences r/t malnutrition or nutritional therapies
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8
Q

Restrictive Bariatric Surgery

A

reduces either the size of the stomach or the amount allowed to enter the stomach

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9
Q

Adjustable Gastric Banding

A

uses a band to create a gastric pouch

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10
Q

Sleeve Gastrectomy (SG)

A

creates a sleeve-shaped stomach by removing about 75%

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11
Q

Biliopancreatic diversion with duodenal switch

A

creates an anastomosis between the stomach & the intestine

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12
Q

Roux-en-Y gastric bypass

A

constructs a gastric pouch whose outlet is a Y-shaped limb of the small intestines

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13
Q

Assistive Devices for obesity

A
  • electronic stethoscopes

- pulse oximetry

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14
Q

Bariatric Surgery Preop

A
  • patient understands surgery & is away of possible catheters, IVs, & SCDs
  • emphasize VS will often be checked
  • will be assisted with ambulation
  • deep breathing & coughing practice
  • liquids started early when patient is awake
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15
Q

Bariatric Surgery Post Op

A
  • VS
  • stabilize airway
  • observe drainage, incision, & infection signs
  • elevate head 35-45 degrees
  • water and sugar free clear liquids
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16
Q

Why are obese patients at risk for re-sedation?

A

anesthetics are stored in adipose tissue

17
Q

Bariatric Surgery: Home Care

A
  • high protein liquid diet
  • eat slowly & stop eating when full
  • no liquids with solids
  • vomiting is common
  • weight loss happens in 6-12 months
18
Q

Why must a possible pregnancy be addressed with a female patient after bariatric surgery?

A
  • pregnancy complications can result from anemia & nutritional deficiency
  • one result of bariatric surgery is the return of fertility
  • postpone 12-18 months
19
Q

Metabolic Syndrome Criteria

A

3/5 of criteria

  • elevated waist circumference (> 35 women; > 40 men)
  • triglycerides > 150
  • HDL < 40
  • HTN (systolic > 130 or diastolic > 85)
  • fasting glucose > 100
20
Q

Lifestyle Modifications for Metabolic Syndrome

A
  • diet low in saturated fats
  • diet to promote weight loss
  • stop smoking
  • increase regular physical activity
21
Q

Oral Cancer

A

mouth and throat

  • more common in males
  • after 35 yrs old
22
Q

Esophageal Cancer Findings

A
  • pain with eating
  • choking
  • hoarseness/cough
  • anorexia/weight loss
  • regurgitation
23
Q

Stomach cancer risk factors

A
  • H. pylori infection
  • pernicious anemia
  • achlorhydria
  • family history
24
Q

Colorectal Cancer risks

A
  • tobacco use & diet high in fat/calories
  • 1st degree relative
  • > 50 yrs old
  • African Americans
  • IBD history & adenomatous polyps
25
Q

Ostomies

A

surgically created opening on the surface of the body

  • ileostomy liquid stools
  • ascending colostomy: semi liquid stools
  • transverse colostomy: semi formed stools
  • sigmoid colon: formed stools
26
Q

Post-op stoma assessment

A
  • every 4 hrs
  • mild to moderate edema
  • small amount of bleeding & oozing
27
Q

Stoma Colors

A
  • Red: good, postop
  • Pale: anemia
  • Dark red-purple: ischemia; inadequate blood supply
  • Brown-black: necrosis
28
Q

When should you change your ostomy?

A

no set time

-usually daily

29
Q

Ostomy Surgery Evaluations

A
  • minimal alteration in bowel eliminations
  • optimal nutrition
  • relief of pain
30
Q

Gallbladder Cancer Interventions

A
  • nutrition
  • hydration
  • skin care
  • pain management

Human Needs (9 decks)

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